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I " , - , i . �� ,,� ,�,."� .�I­ " ` , I ,, ,, ,, ,* ,i...� , ,,, I ,, ''. ., ­� ,��,� ����� , - 4 - �,..,�,'.%� , � ..... , ,� , ,� � �l���,�,."E��,;-.,.-""�,�"",!��;,;��",.t�,, �,i�at, ,i,��4,��,,z,, ,,,,;�.',�;,,,,,�,';'����,,�������.......'A��ii�i";_'I.?,�������������l 1.',T�_11 A I� �dddd��� 53 TOWN OF BARNSTABLE C 2 j (. � 3/ � 024 � �� p ZLOCATION � , E 3 VILLAGE ASSESSOR'S MAP& LOT A/Z INSTALLER'S NAME&PHONE NO. 4 EW R11 e- `a SEPTIC TANK CAPACITY LEACHING FACILITY: (type), (size) NO.OF BEDROOMS / BUILDER OR OWNER v t�01 lZ CA J 9t $ PERMTIDATE: COMPLIANCE DATEOC, °� �� Separation Distance B tween e: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet . Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching`facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by r C Yo J 30.06 THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratiou for Di-lipw3 al lValrkii C omitrurtinu Frrutit Application is hereby made for a Permit to Construct ( ) or Repair ( 4-1-an Individual Sewage Disposal System at: ,. 11 e---------------------------------------------------- Locatio -:\ddress or Lot No. Lew , S << Owner Address W f c>cLf t_t.fie e --------------------------------•--• --••--_US •f-.ry ! ! Ll-2_................a C..`.I a Installer Address Type of Building 3 Size Lot............................Sq. feet ., Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons____________________________ Showers ( ) — Cafeteria ( ) dOther fixtures --------------------------------------------------------------------------------------- ------------------------------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow-------------..............................gallons. WSeptic Tank—Liquid capacity------------gallons Length________________ Width---------------- Diameter---------------- Depth................ x Disposal Trench—No_ ____________________ Width-------------------- Total Length.------------------- Total leaching area....................sq. ft. Seepage Pit No.......:............. Diameter-----------.-------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-------------------------------------------------------------------------- Date........................................ ..� Test Pit No. I________________minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ (i Test Pit No. 2.................minutes per inch Depth of Test Pit.................... Depth to ground water........................ --------------------------------------------------=-------------------------------------------------......................................................... 0 Description of Soil................................................................................................ ................=...=.................................................. U ------------------------------------------•----..---•----------•---•-------•---------------------------------------------------------...------------......................................-............ W x U Nature of Repairs or Alterations—Answer when applicable._.__.._L-4-1J_____l cloka__Q......... __.�'�. �'___...:___. ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed ....... --------- - -------------------------- ..............y:!�--- Application,Approved B34-� & rig Application Disapproved for the following reasons: .................... .................................------------------------------------- -- .. ...... --... ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ ............... --------------------------------------- Date , Permit No. --------(.3 .:'..-.. ..a- Issued C ------- .:...gSJ Date No-,-...' -- .: L, Fps....30..�G.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratuan for Uhnpo al Works (lnntrnrtinn-1prmit Application is hereby made for a Permit to Construct ( ) or Repair ( &-�_an Individual Sewage Disposal System at: r... /-.....------ ---------------------------------------------- Location L -Address I or Lot No. P c-v ► S Owner Address a to �-- LPw � US F�'�v Installer Address Type of Building 3 Size Lot...........................Sq. feet Dwelling— No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons____--__.__.-----.---__----- Showers ( ) — Cafeteria ( ) dOther fixtures --------------------------------------------------------------------------------------- ---------•----=----------------•----...----•-._..........---- W Design Flow............................................gallons per person per day. Total daily flow---------------------------------------------gallons. WSeptic Tank—Liquid capacity---------..gallons Length---------------- Width---------------- Diameter---------------- Depth................ x Disposal Trench—No. .................... Width-------------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------_----------- Diameter____________________ Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by-------------------------------------------------------------------------- Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water_____-.-_-_-------_---.. Li. Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water......................... P4 -----------------------------------•----••-------------------.......---------•--------•......----------------•-......................................... -- 0 Description of Soil.................................................................................................................................................................... V ---....•-•------•-•----••-------•--•--•-------------•-•-----•----------------•---•---•----•------------•----------------•--•----•••-----------------•------------•--•-•••..........-•----•-•-•----•--... W _ UNature of Repairs or Alterations—Answer when applicable___.__. -(_f?___.. 1 rA.0 ._2......... _ _f_ _I._P......::�............. •-------•-----------------------•---------------------------------------------------•-••---•------------------------------------,-------------•---------•----------•-----••-•---•--•------.._............. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with ' the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed - - --S-e_x. ------ Application, `. Approved B +- -------------------------------------...---------.......-------------.------------ --...... �,----_--31.... -....5-.5 PP Y ------------ -- Date Application Disapproved for the following reasons- -------------------------------- -------------------------------------------------------------------------------------------------- -- . ... .............................................._........... . . .. .... . -------------------------------------------------------------------- -----. ........................................ # ,. Date Permit No. ............... ---------3, .... - Issued ..................'A........ C.S ......... Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Ertifi ate of CZomplianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (t/•) by ----------w.CkJ..t e........ t' 2 sti 5------------------------------------------------------------------------------------------------------.----------------------------------------------------- at ........53-1-----.4 n rr-1 S ..__.1�2.!..u..e_�....------lZc.�------------ ----------------------------------------------------------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. _.....Y3_-..a.......... ... j... --- ..5`_. ... ----- dated cf- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. rYDATE.................... / - ---------------------------- Inspector -----------E-- -..I --- -------------------------------------- -------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No..... 5 :.. .�j FE ........................ t UG Disposal Works Tunitrurtion "rrmit Permission is hereby granted 1 a ( � --'- c.`-- to Construct ( ) or Repair (v Tan Individual Sewage Disposal System atNo.....5r5 GLA rn. '.---•-•.R. `Z-e ------er�---•--.-;---------------------------------------------------------------------------------•--......... Street as shown on the application for Disposal Works Construction Permit No._l pp��JZ�__.. Dated........3>5_-.�.��7`�............ 3 1 c/ -�l� BoU of Health DATE ------.....L-----------t ;---------------------- h FORM 36508 HOBBS Q WARREN.INC.,PUBLISHERS i TOWN OF BARNSTABLE LOCATION r'�l I�J�'il/l[�c" U'< ' Uzi ' �G� SEWAGE # > > / VII.LAGE C�`, i'/ r1,�(f ASSESSOR'S MAP & LOT 1 y INSTALLER'S NAME&PHONE NO. i S l y°3 SEPTIC TANK CAPACITY 1 v' LEACHING FACILITY: (type) G �' { P- (size) NO.OF BEDROOMS_ BUILDER OR OWNER Q COMPLIANCE DATE: �- — I4 PERMIT DATE: Separation Distance Between the: g_ 0 Feet Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Private,Water Supply Well and Leaching—facility (If any wells exist Feet on site or o "aching facility) Edge of Wetland and Leaching Facility(If any wetlands exist ,r Feet within 300 feet of leaching faci 'ty) Furnished by '� .'����� . r `� /� L ®,,,CAT ION _ SEWAGE PERMIT NO. VILLAGE IaSTA LLER'S NAME b ADDRESS J , tr.--u tip ® UILDE.R OR OWNER DA T E ' ERMIT I S S U E D •� �L DAT E C 0 M P L I A N C E ISSUED i I � �� ^720- � ' y FEB..-T.." �� ^ THE COMMONWEALTH oF MAssxoeussTrs ������ ���� HEAUH - §�w r ����.'-_-���--' . ` - �~°� °� ���«��lit�u4 u� ��«��� �p�w������wu� Marks Touwitr4ortmwu» Prrutot ' . � Application is hereby made for u Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System ------'----- --------'_------------_-------------------------.. oZ. d � L� N� ---- --==_--------------' ----------------_-------------------'..----'---'_--. Owner Address ---- AM, -_.............................................. -'-----'---------'--'-_----------'---------'-'-___' Installer Address Tvn� ofDo�8�o, Size S '^ Building �� '�� Lot ~� ' ^ I)w�]io0--I�o. c6 De�r000z,------�c�.--_----__-�znaos�u� �tt� (�w9 Garbage Grinder ' Pk Other--Type of Building ............................ No. of persons............................ Sbovrccs ( ) -- Cafeteria (' ) .� Other fixtures '-.---------..--------------..----_---_.._--.---------'----------------- ' Design Flow Q24�� .gallons per person per day. Total daily flow ' -- ----.' ' . ' Disposal Trench--No.........~===-' *uzo`'f=*v���-- Total Lcugco.--.--~~---' Total /eucoogaroa-_-------ug o. Seepage Pb No-'----.-. Diaozctec----.--.. Depth below inJoL_-------- Total leaching area.................sq. ft. ' Z Other Distribution box ()() Dosing tank ( ) - ~~ Percolation Test Results Performed br----.---.-_-------------.--------. Dmr------------------- � Test Pit No. ].-_-'-.oziuutcopor��6 Depth of Test Pi�-----_--' Depth tn ground water------ ................. Test Pit No. 2................minutes per inch Depth of Test Pit'.-------- Depth to ground wuccc--_---'_-- � 0 ..................................................�r- ............................................................................................................................................. .................. ...................................................................................................................................................................................... -~ Nature of Repairs orAltccatiomo--Aoswerwbco applicable-_------------.-------.---------------- ~7 Agreement The undAigned agrees tu in:s�a �thea 9/eescr'bed Individual Sewage Disposal System in accordance with the provisions 5mmc �a� S �� agrees not m place the system in operation until a Certificate cf Compliance has bee ss ed b;y 4t�be h-pard ()f,,V/alth. Signed- '-~----- -------'-'- -'�---�-- . u"te _, - 'Application Disapproved for the reasons:............................................ ---'------'__................................. .....................' Date PermitNo.......................X�Z................ Issued....................................................... Date ~~w~~___ ~-. 4C 4 , ' . ................... .......6.0 No."Ax/ ­. THE COMMONWEALTH OF MASSACHUSETTS -_--,----- BOARD/ HE L-TH tilt ..............­0F....... .....r ............................. .......................................... ppliration for Dispolial Works Tomitrurtion Famit Applicatioh<js"hereby made for a Permit to Construct ( ):1`6r Repair an Individual Sewage Disposal SVst at:240 . ........................................ .................................................................................................. oca;i.. Address or Lot No. '000 ..................... --- ----- Ze(.&�------------------------------ -------------------------------------------.. .............................................. `Owner Address ,4 ... e ....... ..................................................................... ............... . .............................................................................. Installer Pq Address Type of Building Size Lot'.......................... Ft (;.d Dwelling—No. of Bedrooms._...._.._..41.........................Expansion Attic <yn Garbage Grinder aOther—Type of Building ............................ No. of persons......._.............._.____ Showers Cafeteria Otherfixtures ..................................................................................................................................................... Design Flow.._._.C;.6!.4 0c�G gallons per person per day. Total daily flow............................................gallons. -----------Septic Tank—Liquid-capaci..............gallons L th ... Width........_._._... Diameter._....._.._..__. Depth..__.._......_..�ng ............. Disposal Trench—No_.................... Width____.... e.&otal Length....._......._._.__. Total leaching area....................sq. ft. A - Seepage Pit No_____________________ Diameter__....._._.._.__.._. Deptl� ,below inlet.._............____. Total leaching area..................sq. f t. Other Distribution box Dosing tank Percolation Test Results Performed by.................... ..................................................... Date........................................ Test Pit No. I___.....__......minutes per inch Depth'of Test Pit.................... Depth to ground water____.........._.._.____. rX4 Test„!'it ................minute�per inch Depth of Test Pit.................... Depth to ground water.._.................____ Vit No. 2 ............................................I.......................................................................................... 0 Description of Soil---............4­ ------------------*......"..................... .........................................I.............................................. ....................................................................................................... U - ----------------------- -----------------/..... 7*.... -------------**--------------- -- --------------------­------ ................................................................................................................................................ Nature r­'ons—Answer when applicable................................................................................................. U­ of Repairs or Alterations ............................... ....... .... ..........I......................................................................................... . Agreement: )P esc, The undersigned agrees to install the a] escAbed Individual Sewage Disposal System in accordance with - ) �`f& provisions of TITLE; 5 of the State'Sanitary C de r The undersigned further agrees not to-place the system in operation.until a Certificate of Compliance has bee issued by oard o ealth. vy 4 4e"l Signed...................................................................................... .............. Date ................................. ............. Application Approved By........T=t�� ... Date pplication Disapproved for the following reasons:............................................................................................ ............ ..................................................................7..................................................................................................................................... ADate /. PermitNo------............... .......D............... Issued ........................................................ Date THE COMMONWEALTH.OF MASSACHUSETTS BOARD--QF HEALTH 0 F..... ...............m................................................... Ourdifiraft of Tom fiaurr THIS RTIFVThat the Individual Sewage Disposal System constructed (',�r Repaired by............. ll.........a 4,0­ , /j ..................................F ............ ............. ------- ----------­----­ .............. ------ at..........—1A j ................. ................ ................................................................................................------ 7,1,has been installed in accordance with the provisions of TIZ�L7— e State Sanitary Code as described in the application for Disposal Works Construction Permit No______________________kvdated---.._-_:_.:_-.--...__-_-__-. .._...._._.._..... . I 0.XV— THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO TRUE® AS UAR TEE THAT THE SYSTEM WILL.F TISFACTORY. DATE .............. ........ . ... ... Inspector...... .................................................................... ....... ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD ............. ......7 HEALTH.... ... ........... .... ...... .................................... y. 0�j - ................... FEi. ..................... am n riutiott Vit epe , -r . Permission is hereby granted..... ---1100 e4 ., ......... ...................... ------------ ...... to Construe/ R W epai an Individu4�Sewage Disp ysteih atNo...................................I.................4................�J"Aov --------------------1-1......... .................................................... Street as shown on the application for Disposal WoTks Construction Permit No.._.,_,...............-- Dated--------- ......................... -------------­------------------------­------- /Z�,/)'-/,C. Board of Health DATE . ... ........................................................... FORM 1255 A. M. 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